Effects of Neuromobilization, Tendon Gliding, and Robotic Glove-Assisted Exercises on Hand Osteoarthritis

NCT06901024 | Completed

• 1 other identifier: 2022/081
• Study Type: interventional
• Target: 39
• Locations: 1 country
• Sites: 1

Brief Summary

The 2018 update of the EULAR recommendations highlighted that exercise reduces pain and improves functionality in patients with hand OA. This study aimed to investigate the effects of neuromobilization, tendon gliding and robotic glove-assisted exercises on pain, grip strength and hand function in patients with hand osteoarthritis (OA).

Conditions

Osteoarthritis

Keywords

Osteoarthritis; Neuromobilization; Tendon gliding; Robotic Assistive Device

Outcome Measures

Primary Outcomes (4)

• Australian-Canadian Hand Osteoarthritis Index

  The Australian-Canadian Hand Osteoarthritis Index (AUSCAN) is a self-report tool commonly used for the assessment of hand functionality in hand OA. The AUSCAN includes a total of 15 items measuring pain (5 items; 0 to 20 points), stiffness (1 item; 0 to 4 points), and function (9 items; 0 to 36 points) during the preceding 48 hours. Total possible scores range from 0 to 60 points

  8 weeks

• Jebsen-Taylor Hand Function Test

  The Jebsen-Taylor Hand Function Test (JTHFT) is used to assess fine and gross motor hand function when performing activities of daily living (ADLs) and to measure the speed at which they perform the test tasks. The JTHFT is a valid and reliable tool and consists of 7 tasks, including writing, turning over cards, picking up objects, stacking checkers, simulated feeding, and moving light and heavy objects. Participants were asked to perform each task separately for each hand, and the time taken for each task was recorded using a stopwatch

  8 weeks

• Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) questionnaire

  The Quick-DASH short form consists of a total of 11 questions that ask about an individual's neurological symptoms, pain, sleep disturbances and their ability to work and perform certain activities in the previous week. Each item is assigned a score between 1 and 5: 1 (no difficulty), 2 (mild difficulty), 3 (moderate difficulty), 4 (severe difficulty), 5 (unable). Total possible scores range from 0 (no disability) to 100 (most severe disability). The total score is scaled between 0 (no disability) and 100 (maximum symptoms and disability)

  8 weeks

• Pain Intensity

  The Visual Analog Scale (VAS) is a simple, self-administered tool. It consists of a 10-cm line, with the left end representing no pain and the right end representing worst possible pain. Individuals rate their pain intensity by marking a point on VAS, which is scored from 0 to 10.The point marked by the patient on the 10-cm line was measured using a ruler, and the corresponding distance in centimeters was recorded.

  8 weeks

Secondary Outcomes (2)

• Static grip strength

  8 weeks

• Perceived pain

  8 weeks

Study Arms (3)

Tendon gliding group

EXPERIMENTAL

The tendon gliding exercises were applied after conventional exercises.

Other: Tendon Gliding Exercise; Other: Conventional Exercises

Neuromobilization

EXPERIMENTAL

The neuromobilization were applied after conventional exercises.

Other: Neuromobilization Exercise; Other: Conventional Exercises

Robotic assisted exercises

EXPERIMENTAL

The robotic glove-assisted (RGA) exercise group performed passive movements for 60 minutes using soft robotic gloves (Masmel Health, Turkey), in combination with conventional exercises.

Other: Robotic Assitive Exercise; Other: Conventional Exercises

Interventions

Tendon Gliding Exercise OTHER

Tendon gliding exercises were performed for both hands in a sequential manner, with 20 repetitions in 3 sets. The exercises started with fingers and wrist positioned in extension. Subsequent positions included the hook position, full fist position, MCP joint at 90° flexion with finger extension, and MCP and proximal interphalangeal (PIP) joints at 90° flexion positions, with a 5-second hold at each position. During the TG exercises, the hand and fingers are brought to five different positions

Tendon gliding group

Neuromobilization Exercise OTHER

The neuromobilization exercises included median, radial and ulnar nerve mobilizations. For median nerve mobilization, the patient's wrist was placed in extension, the shoulder in 90° abduction, the forearm in supination, the elbow extended, and the head positioned in lateral flexion toward the same side. For radial nerve mobilization, the wrist was initially placed in flexion and ulnar deviation, the forearm in pronation, with the elbow extended, and the head positioned in lateral flexion toward the same side. For ulnar nerve mobilization, the wrist was positioned in extension and radial deviation, the elbow fully flexed, the forearm in pronation, the shoulder in 90°abduction, and the head in lateral flexion toward the same side. The head was then moved into lateral flexion toward the opposite side while extending the elbow. The neuromobilization protocol was performed in 4 sets of 10 repetitions, with a 5-second hold for each movement.

Neuromobilization

Robotic Assitive Exercise OTHER

The robotic glove set used in this study weighs 497 grams, powered by a battery weighing 170 grams that provides a 5 V voltage and 1 A current. Made from elastic fabric, the glove wraps around all fingers on both the dorsal and palmar sides. The palm section of the glove is hollow. The device features four Velcro straps: one at the wrist, one across the web space between the thumb and index finger, one between the second and third fingers, and one between the fourth and fifth fingers, securing the inner side of the wrist. The robotic glove facilitates passive joint movements through pneumatic air pressure. The device offers several benefits, including proprioceptive stimulation, visual input, increased functional independence, pain and edema reduction, enhanced lymphatic and blood circulation, improved coordination and hand dexterity, as well as increased grasp and compression strength.

Robotic assisted exercises

Conventional Exercises OTHER

Wrist extensor exercise, wrist radial deviation exercise, and wrist flexor exercise were perfomed using a 1-kg dumbbell. Holding the 1-kg dumbbell against gravity for 10 seconds, with the shoulder flexed at 90°, elbow extended, and forearm in pronation position. Squeezing exercise with a green soft ball (Thera-Band; diameter: 5 cm); the ball was squeezed for 10 seconds, followed by relaxing. Pushing a blue Pilates ball (Thera-Band; diameter: 20 cm) against the wall with fingers in extension position. Squeezing a black Pilates ring (Thera-Band; diameter: 38 cm) with the fingers, while the MCP joints are in extension and the wrist in a neutral position.

Neuromobilization; Robotic assisted exercises; Tendon gliding group

Eligibility Criteria

• Age: 45 Years - 87 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients were diagnosed with primary hand OA by an orthopedics and traumatology specialist based on the ACR diagnostic criteria.
• Aged 45 to 87 years

You may not qualify if:

• Individuals were excluded from the study if they had a history of major psychiatric disorders, malignancies, systemic or rheumatologic diseases, severe hand trauma or surgery to the hand region within the past six months, prior intra-articular steroid or hyaluronic acid injections into the hand joints, collagen tissue disorders, peripheral vascular diseases, or a history of neuropathy.

Sponsors & Collaborators

• Hasan Kalyoncu University: lead

Study Sites (1)

Hasan Kalyoncu University, Department of Physiotherapy and Rehabilitation

Gaziantep, None Selected, 27144, Turkey (Türkiye)

Location

Related Publications (6)

• Kloppenburg M, Kroon FP, Blanco FJ, Doherty M, Dziedzic KS, Greibrokk E, Haugen IK, Herrero-Beaumont G, Jonsson H, Kjeken I, Maheu E, Ramonda R, Ritt MJ, Smeets W, Smolen JS, Stamm TA, Szekanecz Z, Wittoek R, Carmona L. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis. 2019 Jan;78(1):16-24. doi: 10.1136/annrheumdis-2018-213826. Epub 2018 Aug 28.

  PMID: 30154087 BACKGROUND

• Stoffer-Marx MA, Klinger M, Luschin S, Meriaux-Kratochvila S, Zettel-Tomenendal M, Nell-Duxneuner V, Zwerina J, Kjeken I, Hackl M, Ohlinger S, Woolf A, Redlich K, Smolen JS, Stamm TA. Functional consultation and exercises improve grip strength in osteoarthritis of the hand - a randomised controlled trial. Arthritis Res Ther. 2018 Nov 9;20(1):253. doi: 10.1186/s13075-018-1747-0.

  PMID: 30413191 BACKGROUND

• Horng YS, Hsieh SF, Tu YK, Lin MC, Horng YS, Wang JD. The comparative effectiveness of tendon and nerve gliding exercises in patients with carpal tunnel syndrome: a randomized trial. Am J Phys Med Rehabil. 2011 Jun;90(6):435-42. doi: 10.1097/PHM.0b013e318214eaaf.

  PMID: 21430512 BACKGROUND

• Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev. 2018 Sep 3;9(9):CD006876. doi: 10.1002/14651858.CD006876.pub5.

  PMID: 30175845 BACKGROUND

• Pedersini P, Valdes K, Cantero-Tellez R, Cleland JA, Bishop MD, Villafane JH. Effects of Neurodynamic Mobilizations on Pain Hypersensitivity in Patients With Hand Osteoarthritis Compared to Robotic Assisted Mobilization: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2021 Feb;73(2):232-239. doi: 10.1002/acr.24103. Epub 2021 Jan 3.

  PMID: 31675184 BACKGROUND

• Villafane JH, Valdes K, Imperio G, Borboni A, Cantero-Tellez R, Galeri S, Negrini S. Neural manual vs. robotic assisted mobilization to improve motion and reduce pain hypersensitivity in hand osteoarthritis: study protocol for a randomized controlled trial. J Phys Ther Sci. 2017 May;29(5):801-806. doi: 10.1589/jpts.29.801. Epub 2017 May 16.

  PMID: 28603349 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Officials

• Serkan Usgu

  Hasan Kalyoncu University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: All assessments were conducted by a single physiotherapist, who was blinded to group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of Physiotherapy Department

Model Details: The patients were divided into three groups: neuromobilization, tendon gliding, and robotic glove-assisted exercise group.

Study Record Dates

• First Submitted: March 23, 2025
• First Posted: March 28, 2025
• Study Start: August 23, 2022
• Primary Completion: November 3, 2023
• Study Completion: January 10, 2024
• Last Updated: April 2, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)